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Still Waiting, Still Dying: The Global Fund and Key and Vulnerable Populations in the Response to HIV, TB and Malaria

Aug 2022

Read our updated key and vulnerable population paper, launched during AIDS22 in Montréal: Read the full paper

This year, the Global Fund launched its strategic plan for the years 2023 – 2028. The Global Fund is also currently engaged in its Seventh Replenishment, raising funds for the coming three years, and aiming for at least US$18 billion in pledges.

This paper, developed by the Global Fund Advocates Network (GFAN), discusses the Global Fund’s efforts and challenges to support key and marginalized populations in the response to HIV, tuberculosis, and malaria (HTM). The paper sounds an alarm and describes five key challenges that need to be widely acknowledged and addressed:

  1. Key and Vulnerable Populations: Key and vulnerable populations, while marginalized economically, socially, and legally, are not at the margins of epidemics, but instead are at the center of infection transmissions and loss of life due to the three diseases. For this reason, global epidemic control and achievement of the SDGs depends on key and vulnerable populations being at the center of programming by country governments and international funding partnerships such as the Global Fund.
  2. Funding Gaps: Global resource mobilization targets for the three diseases, although ambitious, fall short of the calculated total resource needs to bring the three epidemics under control. Even if resource mobilization targets are met, there will be an estimated $28.4 billion funding gap. Key and vulnerable populations bear the burden of unequal resource allocations and access to services in every country, and the gap in resource mobilization will disproportionately affect those populations.
  3. Reducing morbidity and mortality: Despite significant progress in most countries in reducing infections, global reports from UNAIDS and others show that we haven’t done enough in preventing new infections and that infection levels continue to soar in many communities globally.
  4. COVID scarring: Over the past two years, the COVID-19 pandemic has resulted in significant setbacks to the progress made to date. 5. No seat at the table: While KVPs are represented on the Global Fund Board and some CCMs, they are often excluded from program and policy development, implementation, and evaluation efforts. This serves to further the inequities and ineffectiveness in service delivery and health care access

Read the full paper

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